Three models of community mental health services In low-income countries.

OBJECTIVE: To compare and contrast three models of community mental health services in low-income settings. DATA SOURCES/STUDY SETTING: Primary and secondary data collected before, during, and after site visits to mental health programs in Nigeria, the Philippines, and India. STUDY DESIGN: Qualitative case study methodology. DATA COLLECTION: Data were collected through interviews and observations during site visits to the programs, as well as from reviews of documentary evidence. PRINCIPAL FINDINGS: A set of narrative topics and program indicators were used to compare and contrast three community mental health programs in low-income countries. This allowed us to identify a diversity of service delivery models, common challenges, and the strengths and weaknesses of each program. More definitive evaluations will require the establishment of data collection methods and information systems that provide data about the clinical and social outcomes of clients, as well as their use of services. CONCLUSIONS: Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for this purpose, it is possible to compare programs and begin to assess the effectiveness of diverse service delivery models.